Individual
MR. MICHAEL LASHANE HOLT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
1400 E DOWNING ST, TAHLEQUAH, OK 74464-3324
(918) 458-2444
Mailing address
11024 W 835 RD, FORT GIBSON, OK 74434-6340
(918) 616-1111
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
205318
OK
Other
Enumeration date
03/25/2022
Last updated
03/29/2022
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